Increasing the uptake of medication-assisted treatment for opioid use disorder

项目摘要 这个K23指导的以患者为导向的研究职业发展奖的目标是支持 申请人在发展必要的关键技能，成为实施循证医学的专家 在社区环境中治疗药物滥用障碍。本K23应用程序建议进行研究， 解决NIDA战略计划目标3.4：制定和测试有效和可持续的战略 实施循证治疗，特别是确定影响有效和 可持续地传播和实施药物使用治疗的循证做法 改善成瘾问题，并改善获得有效干预措施的机会。导师团队由一名 学术-公共伙伴关系，结合临床，学术和公共系统的专业知识，在凯尔坎普曼， 医学博士，Geoff Neimark，医学博士和一个顾问团队。具体的培训目标是：1）深入了解 了解阿片类药物使用的社区药物滥用治疗的组织、筹资和提供 疾病，特别是因为它涉及药物辅助治疗，2）使用基于理论的方法来确定 可以用来加强执行工作的具体组织、执行人员和政策因素 在社区环境中的MAT;和3）发展设计和方法的专业知识， 试行组织战略，在社区环境中增加MAT的使用，其中包括： 基于理论的混合多层次有效性-实施研究设计和B）分析 行政（基于索赔的）数据，以衡量相关成果。K23中提出的研究将 重点关注以前没有采用MAT的机构。先前的研究和我们的试点数据表明， 不采用MAT的人的类别：主要是意识形态/态度障碍的人和 障碍主要是实际的/后勤的。拟议研究的目标是调查这两类 社区提供者之间的障碍，并制定一个资源包，以支持未来的举措， 提高MAT能力。具体而言，申请人建议：1）确定哪些组织因素， 执行董事的特征与物质使用障碍治疗组织的（n = 117）根据鼓励采用MAT的政策决定采用MAT，2）评估实施情况 采用MAT以响应倡议的机构子集的成功， 导致成功实施的组织和心理因素; 3）开发资源 一揽子MAT采用和实施策略，使用现有工具并确定新领域 未来的研究和探索。在这个项目的过程中，申请人将开发关键知识 社区成瘾治疗，实施科学和公共政策的技能，具有专业知识， 经验丰富和成熟的导师团队。

PROJECT SUMMARY The goal of this K23 Mentored Patient-Oriented Research Career Development Award is to support the applicant in developing the critical skills necessary to become an expert in implementing evidence-based treatments for substance abuse disorders in community settings. This K23 application proposes research to address Objective 3.4 of the NIDA Strategic Plan: Develop and test strategies for effectively and sustainably implementing evidence-based treatments, specifically identifying factors that influence effective and sustainable dissemination and implementation of evidence-based practices for treatment of substance use disorders and improving access to effective addiction interventions. The mentorship team comprises an academic-public partnership that combines clinical, academic, and public system expertise in Kyle Kampman, MD, Geoff Neimark, MD, and a team of advisors. The specific trainings goals are to 1) Gain an in-depth knowledge of the organization, financing, and delivery of community substance abuse treatment for opioid use disorder, specifically as it relates to medication-assisted treatment, 2) Use theory-based approaches to identify specific organizational, practitioner and policy-level factors that could be leveraged to increase implementation of MAT in community settings; and 3) Develop expertise in designs and methods for conducting randomized trials of organizational strategies to increase the use of MAT in community settings, which will include: a) theory-based hybrid multi-level effectiveness-implementation research designs and b) analysis of administrative (claims-based) data to measure relevant outcomes. The research proposed in this K23 will focus on agencies that have not previously adopted MAT. Prior research and our pilot data suggest two categories of MAT non-adopters: those whose barriers are primarily ideological/attitudinal and those whose barriers are largely practical/logistical. The goal of the proposed study is to investigate both categories of barriers among community providers, and to develop a resource package to support future initiatives to enhance MAT capacity. Specifically, the applicant proposes to: 1) Determine what organizational factors and characteristics of executive directors are associated with a substance use disorder treatment organization’s (n = 117) decision to adopt in response to a policy incentivizing MAT adoption, 2) Evaluate the implementation success of the subset of agencies who adopt MAT in response to the initiative, identifying malleable organizational and psychological factors that lead to successful implementation and 3) Develop a resource package of MAT adoption and implementation strategies using established tools and identifying new areas for future research and exploration. Over the course of this project the applicant will develop critical knowledge and skills in community addiction treatment, implementation science, and public policy, with the expertise of an experienced and established team of mentors.